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NHS elective waiting list could soon hit five million

Doctors are sticking to their contracted hours to avoid large pension bills

Emily Perryman 9th July 2019

The number of patients in England waiting for non-urgent care such as a hip replacement or hernia repair could soon hit five million, up from 4.4 million currently, NHS bosses have warned.

It follows reports that hospitals are having to cancel
operations because doctors have suddenly begun working to rule in a standoff
over NHS pensions.

Changes to pension rules in 2016 mean rising numbers of
consultants are receiving large bills linked to the value of their pension.

Hospitals are now struggling to find senior doctors
prepared to work more than their planned shifts, which could lead to them
receiving a pension tax bill of as much as £80,000, the Guardian reported.

The Royal Bournemouth hospital in Dorset may have to
cancel scores of operations between now and 27 July because none of its
consultant anaesthetists are prepared to help staff the 53 sessions of surgery,
involving up to 150 procedures, that are currently uncovered.

The situation has arisen because its anaesthetists fear
that by working over and above their usual hours they will end up financially
worse off.

At another hospital the number of patients who have been
waiting more than the 18-week supposed maximum for a planned operation has
risen from 3,000 to 4,500 since April for the same reason.

Dr Tony Goldstone, a consultant radiologist and clinical
director at Hull University teaching hospitals NHS trust, told the Guardian
that in his own trust and up and down the country there are reports of backlogs
of unreported cancer scans, which are higher than they have been for years.

“I am hearing of operating theatres not being utilised
because of the inability to staff them, and rota gaps not being filled as senior
staff are unable to help out,” he warned.

Full-time doctors are usually contracted to undertake 10
“programmed activities” – four or five-hour shifts – a week, but most
consultants do 11 or 12. However, more consultants are dropping sessions
because, by earning less, their pension pot grows more slowly and their risk of
being hit with a big bill is reduced.

Chris Hopson, the chief executive of NHS Providers, which
represents NHS trusts in England, said hospital bosses were finding it
increasingly difficult to provide a normal range of services, especially
“catch-up” sessions of surgery to tackle waiting-list backlogs.

“To quote two examples we’ve heard just this week, a
senior anaesthetist who worked 27 Saturdays last year to reduce waiting lists
has now said he cannot afford to work any extra Saturday shifts this year
because it would give him a large tax bill he cannot afford to pay,” he said. “Another
trust’s medical director, a senior A&E consultant who routinely worked most
Sundays last year and was key to providing safe emergency care for that trust,
is now unable to work any Sunday for similar reasons. In both cases, the
trust’s performance [on waiting times] and the quality of patient care risks
being compromised.”